OBGY Radiology


Case 5 :
(MRI pelvis)
35-year-old female with pain in lower abdomen, following an ultrasound, MRI of the pelvis was performed.
What is the diagnosis?
 
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Diagnosis

Uterine leiomyoma.

MRI for a fibroid? After an ultrasound!

Ultrasound is indeed the gold standard for evaluating uterine fibroids, and their size, number and position. With the benefit of TVS, there is little doubt that the choice of imaging for lower abdominal pain or menstrual irregularities in a woman should be USG.

MRI however shows a slightly greater accuracy than ultrasound regarding the size and number of uterine leiomyomas. T2WI are optimal for the diagnosis of submucosal and intra-mural lesions, since the contrast between leiomyoma and myometrium or endometrium is high.

T1WI are needed for determining the extent of submucosal leiomyomas. However, neither ultrasound nor MRI are able to distinguish between benign cystic leiomyomas and leiomyosarcomas.


Contribution

Dr. Deepak Patkar, MRI Nanavati, Mumbai